Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France; Strategy and Research Department, French National Health Insurance, Paris, France.
Centre for Epidemiology on Medical Causes of Death (CépiDc-Inserm), Le Kremlin-Bicêtre, France.
J Affect Disord. 2020 Sep 1;274:174-182. doi: 10.1016/j.jad.2020.05.071. Epub 2020 May 23.
This study was designed to describe contacts with health services during the year before suicide death in France, and prevalent mental and physical conditions.
Data were extracted from the French National Health Data System (SNDS), which comprises comprehensive claims data for inpatient and outpatient care linked to the national causes-of-death registry. Individuals aged ≥15 years who died from suicide in France in 2013-2015 were included. Medical consultations, emergency room visits, and hospitalisations during the year preceding death were collected. Conditions were identified, and standardised prevalence ratios (SPRs) were estimated to compare prevalence rates in suicide decedents with those of the general population.
The study included 19,144 individuals. Overall, 8.5% of suicide decedents consulted a physician or attended an emergency room on the day of death, 34.1% during the week before death, 60.9% during the month before death. Most contacts involved a general practitioner or an emergency room. During the month preceding suicide, 24.4% of individuals were hospitalised at least once. Mental conditions (36.8% of cases) were 7.9-fold more prevalent in suicide decedents than in the general population. The highest SPRs among physical conditions were for liver/pancreatic diseases (SPR=3.3) and epilepsy (SPR=2.7).
The study population was restricted to national health insurance general scheme beneficiaries (76% of the population living in France).
Suicide decedents have frequent contacts with general practitioners and emergency departments during the last weeks before death. Improving suicide risk identification and prevention in these somatic healthcare settings is needed.
本研究旨在描述法国自杀死亡前一年接触卫生服务的情况以及常见的精神和身体状况。
数据来自法国国家健康数据系统（SNDS），该系统包含与国家死因登记处相关的综合住院和门诊治疗索赔数据。研究纳入了 2013-2015 年在法国死于自杀的年龄≥15 岁的个体。收集了他们在死亡前一年的就诊次数、急诊就诊次数和住院情况。确定了疾病种类，并计算了标准患病率比（SPRs）以比较自杀死亡者和一般人群的患病率。
本研究共纳入 19144 人。总体而言，8.5%的自杀死亡者在死亡当天看医生或去急诊室，34.1%在死亡前一周内，60.9%在死亡前一个月内。大多数就诊是看全科医生或去急诊室。在自杀前一个月，24.4%的人至少住院一次。精神疾病（36.8%的病例）在自杀死亡者中比在一般人群中更为常见，患病率比为 7.9 倍。在身体状况中，最高的 SPR 是肝脏/胰腺疾病（SPR=3.3）和癫痫（SPR=2.7）。
研究人群仅限于国家健康保险综合计划的受益人（居住在法国的人口的 76%）。
自杀死亡者在死亡前几周经常与全科医生和急诊部门接触。需要改善这些躯体保健环境中的自杀风险识别和预防。
